Insulin Pumps, yes or no?

[jessh0ll]

I've been type one diabetic a year, I've heard about pumps but I don't know much about them, is it worth getting one or is it better to stay on pens?

 

[noblehead]

If your happy using pens and don't have any issues then continue as you are, pumps are great but they are not for everyone, also you have to have a clinical need to change to a pump and can't just decide that you want one as funding needs to be pre-approved after a consultants recommendation.

 

[Gaztheoldpunk]

Not for me... been type 1 for long enough to be perfectly happy with injections, anyway, the pump will get in the way of my bass guitar & I don't fancy wearing a pump in a moshpit.......!!!

 

[mattmo86]

Would love a pump, have no control using injections, I'm getting changed onto toujeo in a few weeks to see if that makes any difference to bloods.

I'm not sure of the criteria to meet to get a pump, but it is something that is always talked about in my appointments.

 

[noblehead]

Would love a pump, have no control using injections, I'm getting changed onto toujeo in a few weeks to see if that makes any difference to bloods.

I'm not sure of the criteria to meet to get a pump, but it is something that is always talked about in my appointments.

You have to meet the NICE criteria or your consultant could put a case forward using one or more of the ABCD recommendations:



NICE criteria, Technology Appraisal 151 (2008)
Only applicable to type 1 diabetes (there is insufficient evidence to routinely recommend pumps in type 2 diabetes, except for individual cases)

• Under 12 years old: MDI is inappropriate or impractical

• Aged 12 or older: hypos occur frequently or without warning, causing anxiety about recurrence and a negative impact on your quality of life
OR your HbA1c is still 8.5% or above despite carefully trying to manage your diabetes, including the use of Lantus or Levemir

If you meet the NICE criteria and your consultant recommends pump therapy, you have a right under the NHS Constitution to access it on the NHS.

If you don’t meet the NICE criteria but you do fall under recommendations from the Association of British Clinical Diabetologists (ABCD), your clinic will need to make a strong case for you to be granted funding

ABCD recommends that insulin pump therapy is also considered in the following situations:
• Pregnancy
• Acute painful neuropathy or symptomatic autonomic neuropathy if
conventional treatment fails to enable adequate blood glucose control
• Hypoglycaemia unawareness
• Extreme insulin sensitivity
• Needle phobia
• Severe insulin resistance with poor blood glucose control
(especially if type 2)
• Specific quality of life issues:
– Pathological fear of hypoglycaemia
– Marked glycaemic excursions/dawn phenomenon
– Excessive number of injections for optimised control
– Impaired exercise capacity, abnormal eating behaviour or an unacceptable number of sick days
– Shift work or frequent travel across time zones
– In children: sub-optimal school performance, exclusion from aspects of a full school life; behavioural problems (for example, mealtimes); adverse impact on family dynamics

http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

 

[mattmo86]

I would say I fall under a few of the recommendations from ABCD, I am sensitive to insulin, sometimes on needing 1 or 2 units to bring me down, especially when I'm working, I work constant nights, with awful sleeping and eating routines, I also tend to inject a lot, injecting for food and then again for correcting high glucose.

It will definitely be something that I talk with my team about the next time I meet, in a few weeks.